Medications play a key role in treatment of persons with major mental illnesses, yet adherence rates (about 50%) are about the same as for other long-term illnesses. Shared decision making between consumer and healthcare provider is becoming increasingly popular in non-psychiatric illnesses, especially in chronic diseases. Whereas medication adherence has been extensively studied, the decision-making process regarding medications has not been examined as it relates to this phenomenon of shared decision-making. This study proposes to measure decision-making capacity, preferred and actual degree of client participation in the client-provider interaction and examine their relationship to medication adherence attitudes and quality of life in persons with serious mental illness. This will lay the groundwork for more extensive inquiries into shared decision-making as it applies to this population and to interventions that demonstrate greater effectiveness in actually improving the lives of the seriously mentally ill. [unreadable] [unreadable]